Cross-Post: How I Spent My Sunday

Cross-posted from The Neophyte Photographer (Originally posted on Monday, March 18, 2013)

Long-time followers know that I photographed the first ever Medical Outreach Response Event (MORE) last year as my final project for my lighting class.   They held the event again this past weekend and I volunteered to shoot the event. They already had a photographer for Saturday so I showed up yesterday.  Sunday wasn’t as busy as Saturday, but there was still plenty of need.   There are no medical services to speak of in our town. Many of these people are working poor, or disabled, and there are so many hurdles for them to jump over and so many cracks for them to fall through, that the problem feels insurmountable.

Here are just a few shots.

Attendees starting the process at intake.  The clients were screened here and directed to the various areas, depending on their need.

They might need dental work, vision care, help with obtaining affordable insurance or low-cost prescription assistance.  Or all of the above. There was also an immunization clinic to get people up-to-date on their shots, mental health screening, three dental vans, and the Mammovan was there to provide breast cancer screening.

 People shouldn’t have to get their health care in the middle of a high school gymnasium or get their teeth fixed in the parking lot. My country has its priorities all screwed up.

They shouldn’t have to wonder if there is something . . .  anything . . .  they can afford.

A young boy attempts to read the eye chart as the Lions Club volunteer looks on.

Immunization clinic.

She’s a bit nervous.

But she came through with flying colors.

More to come.

Press Release: First of Its Kind Event Happening in Nevada, April 13-14, 2012

I will be the official photographer of this event. I’m honored and excited.  From what I understand, dentists are still really needed. They’ve got open chairs and not enough dentists have stepped up (though 300 of them have been contacted).

A few of the photos I’ve already taken can be found here.

April 10, 2012

For Immediate Release

First of Its Kind Event Happening in Nevada, April 13-14, 2012

Medical Outreach Response Event (MORE) to Provide Rural Nevadans
with Healthcare Services

Lyon County, Nev—Over 600 people from Lyon, Storey and Mineral Counties will receive free health care services this weekend. Most people who have applied for services are employed but cannot afford the skyrocketing cost of insurance or healthcare services, especially dental care.

 

Who organized this event and why? The free health care event was initiated by the non-profit Healthy Communities Coalition of Lyon and Storey Counties, a group which includes over 100 local, state, federal and tribal agency partners and hundreds of community volunteers. The primary purpose of the Medical Outreach Response Event, or MORE, is to provide vision, mental health, dental, and preventive care for residents of this underserved three-county region.

When and Where: The event will be held at the Silver Stage High School, 3755 West Spruce Street, Silver Springs, Nevada, on Friday, April 13, from noon to 5pm and Saturday, April 14, from 9am to 5pm.

Who can get services and what are those services? For those who applied by March 23, medical screening, dental, mental health and/or vision services and medical insurance counseling will be provided. For Lyon, Storey, and Mineral residents who did not apply by March 23, free “walk-in” services including HIV tests with instant results, STD risk reduction counseling, and vaccinations for uninsured adults and children as well as access to a health information fair and educational clinics by the Carson Tahoe Wound Care Clinic, will be available.

Who is volunteering? MORE is made possible by the generous commitment of staff from dozens of Nevada health care, social service, nonprofit, and emergency preparedness agencies, as well as the work of hundreds of community volunteers and support from the Lyon County School District.

Long-term Impact: Organizers say this event will lead to long-term improvements since volunteers will help people identify and sign up for medical systems for which they qualify, such as veteran’s benefits, Access to Healthcare Network, reduced cost prescription drug plans, and affordable mental health care. Some vouchers for follow-up care, such as colonoscopies, mammograms, and dental exams will be available.

Christy McGill, Director of Healthy Communities Coalition: “People have been asking why we’re doing this. My answer is that volunteers from all over Nevada are working at this event because every member of our rural Nevada family deserves basic healthcare. We’re doing this because we can, because we should, because our neighbors and our families are valuable to this great state.”

It may have saved my life, it could save yours

Screening Pap Smears Tied to Higher Cure Rate

Women with screen-detected cervical cancer had a 26% absolute increase in cure rate as compared with women who were symptomatic at diagnosis, results of a Swedish study showed.

Even among symptomatic women, the cure rate was 14% higher in those who had been screened according to recommendations as compared with women who were overdue for Pap smears, according to Bengt Andrae, MD, of Uppsala University, and co-authors.

My story: I was in my mid-thirties when a routine Pap smear (at Planned Parenthood, by the way) detected cervical dysplasia. They referred me to UCSF Medical Center for evaluation. Following a colposcopy and cone biopsy that confirmed precancerous cells, I was treated with cryotherapy which was not successful. However, a second treatment using laser ablation did the trick. Twenty years later I still heave a sigh of relief at every clear Pap.

Mark it on your calendar. Get screened.

Lyon, Storey and Mineral Counties: Health Care Event For the Under-Insured

Press Release:

Health Care Event For the Under-Insured

Coalition partners and volunteers are working together to host a free health care services outreach event for under-insured residents in the Lyon-Storey-Mineral region on Friday, April 13 and Saturday, April 14, 2012. The event, known as Medical Outreach Response Event or M.O.R.E., will bring over 100 groups together to offer primary care, dental care, and mental health care as well as referrals to those who have no insurance or are under-insured. Because our rural Nevada populations are not large enough to support for-profit or even non-profit models of traditional healthcare, many rural residents are missing preventative care and often using emergency rooms for their medical care.  This model is extremely expensive in both dollars and human suffering, and it is not a sustainable one.

At this two day event, professionals will

1. Work together for lasting change by connecting patients to systems of care so they can access preventative care, treatment for chronic illnesses, and can prevent emergency medical care
2. Create new partnerships between rural and urban healthcare providers that will benefit rural residents
3. Recruit more medical volunteers from the area into the Medical Reserve Corps and
4. Use this event as a practice for a major public health emergency.

Please help us support these clinics by volunteering for a day, or multiple days. We need MDs, RNs, EMTs, DDS/DMDs, OMSs, RDHs, DAs, Ophths, ODs, Opticians, Op Techs, behavioral health professionals, business and media sponsors, and general volunteers. To volunteer, please contact Christy McGill or Freida Carbery at Healthy Communities Coalition at (775) 230-4210 or 246-7550

http://www.healthycomm.org/Home.shtml

More information:

You can find the application for the free medical, dental, and mental health care event for the Lyon, Storey and Mineral region, or MORE, on the home page of Lyon County School District.  We will also be distributing the forms through social services, food pantries, etc. over the next few weeks.

Follow this link to find the application:

http://www.lyon.k12.nv.us/education/district/district.php?sectionid=1

Saying good-bye to the pink ribbon, but not the cause

Tabling in Dayton, NV

Long-time readers are aware of my very active political background. I have served on our local party committee and worked for the DNC as a field organizer in rural Nevada.  I believed in the party. Four years ago I was a staunch Hillary Clinton supporter and there was much ugliness directed at people like me in that election from my own party.  It’s a fact, and I’m not going to sugar-coat it.  Sadly, it was a very divisive time and when I finally stepped away from the Democratic party I wanted nothing to do with activist politics. This isn’t to say I stopped being interested in politics, but I was sick to death of the tribalism of it all, Left and Right.

2005

However, I am a helper at heart. I like causes. I like thinking that I am making a difference, even if it is just one person at a time.   In May 2007 I started the job I currently hold. It is a large company (multinational) with about 400 employees just at our site alone.  In addition, over the years I had participated in the Northern Nevada  Susan G. Komen Race for the Cure as an individual and on occasion I would be joined by my daughter or a friend.

2009

When I went to work for my very large company I was very excited about the prospect of participating in the race on a team. When I found out that our company did not already have a team I formed one and got about 29 of my co-workers and their family and friends on board.  We raised a couple thousand dollars, as I recall.  It became an annual tradition, and over the years our team has grown to average about 50 members each year.  Over the course of those five years, we raised well over $20,000.

2010

In 2008 I volunteered to serve on the race committee and, in addition to my team captain role, served as the Database Chair for the next four years (2008-2011). For the last two years I also served as the In-Person Registration Chair (in addition to my team captain and database duties).

I’ve tabled for Komen, attended its national conference, personally given hundreds – if not thousands – of dollars to the cause.  I even served on the board of the affiliate as its secretary for about two years.

When I commit to a cause, this is what it looks like:  Full bore, pedal to the metal.

I am not a breast cancer survivor but have had too many friends and relatives affected or killed by this disease.  Just this week one of my co-workers, a young mother of two, underwent a radical bilateral mastectomy. So this is personal. Big time.

In 2009 I wrote this about my experience with Susan G. Komen:

The women I work with at SGK are a varied lot. But one of the things I love most about serving with this wonderful group of women (and men) is that when we are in a room together, all thoughts of political, religious or philosophical differences go out the window in our pursuit of a cure and assistance for those diagnosed with breast cancer.

That all got blown out of the water this week and it is why I’ll never give another dime or moment of my time to this organization. And all the back-tracking and weasel words in the world won’t change that.  Linda lays it out in a very blunt and to-the-point message.

Going forward my cancer research donations will go to the American Cancer Society, and locally I will support Moms on the Run who help not only breast cancer patients but women with other women’s cancers as well. And yes, Planned Parenthood can count on donations from me as well. I’ve taken this fantastic organization far too much for granted and it’s time to give back.

     

A couple of items

Go read: 272 billion reasons to feel depressed

On another note, I won’t be bugging any of you to support me in the Susan G. Komen Race for the Cure this year. In case you missed it, here’s why.  For years the local affiliate has had to deal with this nonsense, and it is beyond depressing that the national organization has taken the coward’s way out.

Locally, I will likely support Moms on the Run whose sole mission is to assist breast cancer and other women’s cancer patients in our area.  No lawsuits for “brand infringement.” No buckling to right wing pressure. Looks good to me. Nationally, I’m looking at the National Breast Cancer Foundation.  And yeah, I’ve made a donation to Planned Parenthood. You should too.

Our first critique night in our lighting class is tonight. I’ve got white spheres, cylinders and cubes dancing in my dreams. And not in a good way.

Well, well, well

At this point, one would have to ask, why is this drug still on the market? It’s not as effective as the one it is supposed to replace, and for others it appears to be deadly.  This is the same drug I took three (3) doses of in November 2009 and reacted so badly to that I stopped it immediately.  I discovered in my own research that my kind of heart rhythm issues did not make me a candidate for this medication so one has to wonder what my cardiologist was thinking when he prescribed it.

We made sandwiches

Twenty years ago I was the general manager at Carrows in Foster City. Twenty years ago, from October 19 – 23,  the Oakland Hills were ablaze. Standing by helplessly has never been my strong suit, so we did what we could.  The firefighters needed food, and people from all over were helping out.

We made sandwiches. Roast Beef. Turkey. Dry. We’d heard stories of firefighters stuffing sandwiches in their jackets to eat later and getting sick from the mayonnaise.  We wrapped cornbread into individual portions. And then we tucked it all in the back of my ’89 Dodge Colt.

It was dark by the time I left the restaurant and as I drove across the San Mateo bridge to head north to Oakland, I saw the hills on fire. The eeriest thing I’ve ever seen.

The effects of that fire are still being felt today and that is something for Sweetie and I to keep in mind as we navigate the aftermath of the air races crash.

As victims began to deal with the trauma of the fire, their dreams also began to change. People dreamed of confronting overwhelming physical obstacles — tidal waves or floods, metaphors for the fire — directly and often successfully. After months of therapy, one heavily traumatized survivor dreamed of fending off environmental terrorists who had invaded his neighborhood.

“As you work out the trauma, there are trial-and-error stages,” Siegel said. “Nine months after the fire, this guy saved his neighborhood from environmental terrorists in a dream. There you can see the evolution of resolution.”

Siegel also found that people who had escaped the fire without significant damage to their homes or their loved ones were wracked with the worst cases of post-traumatic stress. They were bedeviled by survivor’s guilt because the community perceived them — mistakenly, it turned out — to be immune from trauma and fear.

The Mission, Part 1

As you can all see, it’s been awhile. Nothing is flowing from these fingers, and it’s not because I haven’t been thinking about writing. It’s just that what I’m thinking about has nothing to do with politics, nothing to do with what’s passing for news out there. I glance at the headlines and hear whispers that Rick Perry’s popularity may have crested, and that he needs to “revive” his campaign. Revive it? It barely has gotten started. I heard something about his ranch and a racist slur and I think, Why is everyone so surprised?  Chris Christie in? Nope. Sarah Palin? Nah. 

In other news, the Republicans are threatening to hold their breath and throw a tantrum in the grocery store if the Ds don’t give them more tax cuts. Same song, different day.

In the meantime, the recession has officially been over for two years (for who?), but only the 1% are seeing it. The economy isn’t improving, yet companies are still expected to provide profit to their shareholders, so the real backbone of the company (that would be the employees) are asked to squeeze more blood out of the proverbial turnip with no guarantees that said bloodletting will even guarantee them a job next month.  Occupy Wall Street is gaining steam. Will that lead to fundamental change? I hope so.

But. All of the above is merely static.

In a year that has seen, to name just a few, the death of a friend, the murder of a co-worker, the passing of two of our beloved pets, the dissolution of our daughter’s marriage, and the Reno Air Races crash on September 16th, I can only focus on doing the things we need to do to get through to the other side as emotionally whole as possible.  And while the world may have paused in shock and grief for a few days after the accident, it has mostly moved on. That is as it should be. Life is for the living. But for us and many others the trauma lingers. It comes at odd times. When I see flashing police lights. I no longer think, Someone’s getting a ticket.  Now I think, every damned time, Someone is hurt.  Planes coming in for a landing too close to the ground startle me.  Planes making the full-throttle steep ascent out of Reno-Tahoe airport are so reminiscent of Galloping Ghost’s final split seconds, that they send my heart racing too.  Images of the day appear unbidden at the oddest times. I don’t know what sounds, sights or smells trigger Sweetie’s flashbacks, but I know he has them. Sleep, for him, is still an issue and so he is tired much of the time.  At this point, we can only focus on the here-and-now and not clutter our lives up with shit that is still going to be shit tomorrow. It has only been three-and-a-half weeks, but it feels so much longer.

After the accident we wanted to make some sense of it, but it was clear immediately that there was no sense to be made. That has been our answer to every fool who tries to tell us that there must be a reason.  No, there isn’t. It was an accident. A horrific, life-changing accident and there is no cosmic lesson we are required to learn. There is no why other than this:  In a matter of seconds a piece of the plane broke off, causing the plane to careen out of control, causing the pilot to black out, and ultimately, causing the plane to crash into a crowd of spectators. People died. People were maimed – physically and emotionally. If the plane had crashed on the other side of the field, we wouldn’t be having this conversation. But it happened. And it happened where it did. And we’re just having to deal with it. 

Sweetie and The Nurse

In the immediate aftermath of the accident Sweetie started talking about The Nurse. The Nurse who grabbed him as he came running into the carnage. The Nurse who took a look at one victim and said, “He’s not breathing. Come with me.”  The Nurse who moved to another pile of humanity, still alive, but minutes from bleeding to death.  The Nurse told him to tourniquet the man with two missing legs. “Use your belt,” The Nurse told him.  He did. But he needed a second belt and yelled for it – or did The Nurse? A second belt appeared across his shoulder. He pulled that one tight as well and then held on for dear life.  And all the time The Nurse moved between the four lying there and yelled for Number 1′s!  The Nurse was Sweetie’s touchstone. It was her voice that kept him moving through the awfulness. 

So you can understand why Sweetie wanted to know who she was. To find her. To talk to her again. We knew she was from St. Mary’s. That was all we knew. And Sweetie’s recollection of what people looked like was distorted by what he saw that day. Oil, blood, body parts, more blood. He thought she was a tall  muscular woman with dirty blonde hair.

I made it my mission to find The Nurse.

To be continued . . .

This is data mining we could use!

According to the GAO, the FDA does a piss-poor job of analyzing its recalls:

Cardiac devices are the most common source of FDA device recalls, a new report from the Government Accountability Office (GAO) has found [1]. What’s more, the FDA is not taking full advantage of the data it collects from medical-device recalls to prevent safety problems before they arise, the report concludes.

Rather than pursuing a strictly case-by-case approach to overseeing recalls, the FDA “could take a more proactive approach to its oversight,” GAO states in its report. “The agency has a plethora of data available on thousands of recalls but, at present, is not effectively reviewing and analyzing these data in a systematic manner. More routine analyses of these data could help the FDA identify trends in the numbers and types of devices being recalled, as well as the underlying causes of device recalls.”

And I thought, Well, quit cutting their budget then.  Turns out the FDA didn’t actually understand the full capabilities of their database.

“In fact, FDA officials appeared to be unaware of RES’s capability to generate summary data.” The GAO reports that when its investigators requested certain RES data from the FDA, the FDA staff was unable to extract these data themselves and initially indicated that obtaining the data was impossible. But then, two months later, FDA officials were able to meet GAOs request with the help of an outside contractor.

Where have I seen this story before? This is not limited to government. Company gets a system with all kinds of bells and whistles  – hurry, hurry, hurry to implement it, but doesn’t bother getting enough (or the right) people trained on it. Or the one “super-user” who was the sole go-to person on the software leaves the company. Or, there is very little money allocated for training of internal staff at all, and the company depends on the original vendor to provide that service, but the cost to bring them in after the initial contract has completed is so high, who can afford it?  

And then there’s this:

Frequent critic of FDA’s recall system Dr Rita Redberg (University of California, San Francisco) told heartwire, “The fact that there isn’t currently any system for systematically looking at the number of serious adverse events is clearly a problem that is acknowledged in this report.” Redberg said that when she wrote about the series of adverse events with inferior vena cava filters in the Archives of Internal Medicine in 2010, the FDA’s inability to monitor adverse-event reports was “shockingly brought to my realization. . . . I asked [the FDA] why they waited until we ran the story to issue a warning since [adverse-event] reports had been coming in for about 10 years, and they said they hadn’t been aware of all of those reports because they don’t have a system for flagging when serious adverse events are coming in on these devices.

“The FDA is obviously seriously underfunded for its work, and a priority has not been tracking device problems and recalls,” she said. “Industry largely sets the agenda, and their agenda is focused on faster device approvals, but there has unfortunately been woefully little attention on the risks and the problems that happen after device approval.”

Money. Desire for, on one part. Lack of, on the other.

The GAO report concludes with several key recommendations, including that the FDA create a program to routinely and systematically assess device-recall data to proactively identify strategies for mitigating device-related health risks. The FDA has said in response that it plans to perform a “systematic evaluation of potential recall analyses,” looking at recall processing times, device types, types of device failures, quality of recall notifications, and other elements that affect public risk.

The GAO also asks the FDA to clarify its procedures for medical-device recall audit checks, to develop explicit criteria for assessing the effectiveness of recalls, and to do a better job of documenting its reasons for terminating a recall once it has decided the recall is complete. These are all areas the FDA now says it is addressing.

Okay, Congress, give them the money to do this. Quit cutting their budget!

And just once, could industry not come up with a knee-jerk nothing-to-see-here reaction? It just makes you guys look bad.

Janet Trunzo, executive VP for technology and regulatory affairs at AdvaMed, a trade organization for the medical-device industry, told heartwire in an email that “nothing in the GAO report suggests a lack of diligence or inadequacy in medical technology companies’ implementation of recalls.”

She also points out that in addition to its recall authority, the FDA has comprehensive quality system requirements, mandatory adverse-event reporting requirements, and authority to order companies to conduct postmarket surveillance. However, AdvaMed agrees with the GAO that “the FDA could do more to enhance the clarity and consistency of its recall process, and we are pleased that the agency has a number of initiatives under way in this area.”